Maryland Achieves Success Through Thoughtful Planning

February 18, 2025 | Marta McMillion, Sara Bell, Melissa Touma

The Maryland Department of Health (MDH) is committed to improving the health of Maryland residents through thoughtful planning, community engagement, and evidence-based practices. This commitment was a top priority as MDH completed its State Health Assessment (SHA) and State Health Improvement Plan (SHIP). The Public Health Infrastructure Grant (PHIG) offered an opportunity for the agency to drive resources towards building their skills and capacity in the foundational capabilities—assessment, community partnership development, and equity—and to leverage technical assistance (TA) from ASTHO, a national PHIG partner. Throughout its months-long health improvement planning process, MDH achieved significant milestones including gaining valuable insights into the community’s health and developing the SHIP through collaboration. These activities played a crucial role in MDH’s success reaccreditation by the Public Health Accreditation Board.

A Collaborative Approach to Planning

During the summer of 2023, MDH began updating its SHA and SHIP. MDH quickly recognized the need for a streamlined and efficient approach to developing its SHA and SHIP. MDH centered a collaborative approach for health improvement planning with a defined structure that included planning workgroups and aligning community and department priorities. MDH’s aimed to implement evidence-based engagement strategies to ensure the success of these collaborative efforts. This undertaking called for significant coordination, thoughtful planning, and a willingness to adapt to the evolving needs of their communities and partners. To successfully complete their planning goals, MDH engaged with ASTHO TA providers to help the core SHA/SHIP team navigate complex planning and decision-making processes, center collaboration, and refine their approach to asking insightful questions that drove meaningful dialogue with partners.

MDH’s SHA/SHIP initiative, under the coalition name of “Building a Healthier Maryland,” kicked off with the development of a diverse steering committee to guide assessment and planning activities. From December 2023 to March 2024, committee members conducted a comprehensive review of primary and secondary data, performed root cause analyses on identified health concerns, and prioritized five key health areas for action. These priority areas then became the focus of workgroup meetings, during which goals, objectives, strategies, and metrics were developed to drive measurable progress.

Key successes of the SHA/SHIP process included MDH adopting a participatory, community-driven approach aligned with the Mobilization for Action through Planning and Partnerships framework. This approach supported representation and engagement from Maryland's diverse communities and focused on equity-driven objectives that align with MDH’s commitment to addressing health disparities. MDH received 4,892 survey responses from individuals across Maryland. The survey was distributed statewide via various channels including social media and email and with help of key partners who pushed the survey out to their networks. Despite challenges in rebuilding momentum post-pandemic, the collaborative process established a strong foundation for sustainable health improvements in Maryland. While not the sole reason, the new SHA and SHIP contributed to MDH achieving reaccreditation through the Public Health Accreditation Board in December 2024.

Innovative Virtual Engagement

A standout aspect of Maryland’s success in updating its SHA and SHIP was its effective use of virtual engagement techniques. The MDH team leveraged innovative tools to foster collaboration across diverse partners, ensuring inclusivity and broad participation despite any real or perceived geographical and logistical challenges.

Key virtual engagement methods included:

• Breakout Rooms: Small-group discussions encouraged focused dialogue and enabled participants to dive deep into specific priorities.
• Intentional Questioning: Thoughtful, open-ended questions were used to spark meaningful conversations and surface critical insights. 
• Strategic Silence: Facilitators utilized pauses to allow participants time for reflection, leading to more thoughtful and actionable contributions.
• Interactive Tools: Polls, shared documents, and other virtual collaboration platforms helped maintain engagement and capture real-time feedback.

These approaches not only enhanced the efficiency of the planning process but also fostered a sense of connection and purpose among participants. An external facilitator with expertise in community engagement and virtual facilitation also played an important role. Her guidance, supported through PHIG resources, helped MDH maximize the impact of these methods, ensuring the process was inclusive, intentional, and aligned with Maryland’s priorities.

For agencies looking to replicate Maryland’s success, ASTHO has developed a Virtual Engagement Toolkit to help organizations design and implement effective virtual engagement strategies. This resource offers practical guidance on creating dynamic and productive virtual spaces, ensuring teams can achieve their planning goals.

Lessons Learned

Maryland’s experience offers valuable lessons for other agencies:

1. Plan Strategically: Developing the SHIP as an initial foundational plan can provide critical insights and data for other organizational planning processes and make them more efficient and effective. For example, SHIP priorities may inform organizational strategic plan priorities.
2. Embrace Iteration: Accreditation and thoughtful planning are iterative processes. Agencies should anticipate revisiting and refining their plans as they progress.
3. Organization is Key: As one team member advised, “Get really organized and figure out who you’re going to need help from and for what.” Clear roles and responsibilities are essential for successful planning.
4. Leverage Expertise: Engaging expert facilitators or coalition builders can bring unique skillsets to the table, enhance the planning processes, and help grow the capacity of your team. Their specialized knowledge can foster collaboration, guide, complex discussions, and ensure that planning efforts are inclusive and impactful.
5. Don’t Wait: The work involved in these processes often takes more time than you might expect, but the rewards are well worth the effort. Starting sooner allows for a more proactive approach to addressing challenges.

Celebrating Success

While the SHA and SHIP planning processes are significant on their own, the MDH team also simultaneously undertook efforts to enhance their performance management with additional TA support. Despite having limited time to accomplish the SHA and SHIP and enhance the performance management system, MDH successfully overcame this hurdle by staying focused and prioritizing their efforts. Through all these combined efforts, MDH aligned its SHA and SHIP processes and strengthened its performance management system. This alignment has strengthened their ability to set and monitor priorities, allocate resources effectively, measure progress toward public health goals, and maintain their culture of quality.

MDH’s journey showcases the power of intentional collaboration, the value of thoughtful planning, and the rewards of perseverance. By sharing their story, they inspire other agencies to embark on similar planning paths with confidence and clarity.

If your health agency wants more information about planning support, please submit a PHIG technical assistance request through PHIVE or contact performanceimprovement@astho.org for additional planning tools and resources.